Admission/Discharge Criterion for Acute Care Surgery Patients in the ICU: A General Review of ICU Admission and Discharge Indications

Abstract

Surgical patients requiring intensive care unit [ICU] care originate from a variety of admitting primary services and may require critical care services at any time during their course of illness. This care spectrum can range from routine postoperative monitoring of complex cases to resuscitation to restore normal physiology and correct metabolic acidosis, hypothermia, and coagulopathy. This chapter will discuss admission and discharge criterion for acute care surgery patients in the ICU. Additional concepts to be discussed include the use of rapid response teams as an aid to ICU triage, ICU organization, frailty of patients in advanced age, clinical scoring systems, futility versus care that is appropriate for a given diagnosis, advanced directives, ICU economics, communication best practices, and family engagement. It is imperative that acute care surgeons practicing around the world, in hospital models with variable resources, understand these concepts to optimizing patient care.